Justin Mygatt, MD, PHD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

0101259456 Issued in VA

Practice address

300 E Hospital Rd
Fort Gordon, GA 30905

Phone

(706) 787-2862

Fax

(706) 787-7201

NPI assigned

Feb 27, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: jmygatt33390@direct.virginiahospitalcenter.net

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1770908717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E HOSPITAL RD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "30905",
            "telephone_number": "706-787-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E HOSPITAL RD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "30905",
            "telephone_number": "706-787-2862",
            "fax_number": "706-787-7201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208890004",
            "country_code": "US",
            "telephone_number": "301-295-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYGATT",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-27",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101259456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Senthil Mudaliar, MD
• Ian James Mukisa, PA
• Sally Mulholland
• Terrence Scott Murphy, DDS
• Alison Camille Murray, RN
• Michelle S. V. Napper, FNP-C
• Amrutha Nataraj, M.D
• National Vision, Inc.
• Richard Sean Neary, PH.D.
• Harry D Nelson-Abbott, M.A.

• Urology Physician in Fort Gordon, GA
• Providers in Fort Gordon, GA by specialty
• Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.